From $15K to $15M

Jeffrey G. Jarvik,
M.D., M.P.H., a professor
of radiology and neurological
surgery and adjunct
professor of health
services at the University
of Washington, received
his first research grant, a
$15,000 R&E Foundation
Seed Grant, in 1994. His
study compared the outcomes
and cost effectiveness
of patients with low
back pain who received
either a rapid screening
MR or plain films of
the lumbar spine. Dr. Jarvik continues
comparative effectiveness research on
low back pain today, but on a much larger
scale.

In 2010, Dr. Jarvik received a 3-year,
$10 million R01 grant from the Agency
for Healthcare Research and Quality
(AHRQ) to establish the Back Pain
Outcomes using Longitudinal Data
(BOLD) project, evaluating prospectively
the effectiveness, safety and costeffectiveness
of early, advanced imaging
and interventions for elderly patients
with back pain. The project included an
observational cohort of over 5,000 seniors
with back pain as well as a randomized
controlled trial comparing epidural steroid
injections plus lidocaine to lidocaine
alone for patients with
spinal stenosis. The
results of this study will
be published later this
year.

With a new $6 million
National Institutes of
Health (NIH) UH2 grant,
Dr. Jarvik will oversee a
multi-institution, pragmatic,
randomized controlled
trial to determine
the effectiveness of a
simple, inexpensive and
easy to deploy intervention—
inserting epidemiological
benchmarks into lumbar spine
imaging reports—at reducing subsequent
tests and treatments. “Even without back
pain, magnetic resonance (MR) imaging
of the lumbar spine frequently reveals
findings such as disc desiccation or
bulging which may initiate a cascade of
events leading possibly even to surgery,
without improving patient outcomes,”
states Dr. Jarvik. “If our study is positive,
adding epidemiologic benchmarks
to diagnostic test reporting could become
the dominant paradigm for communicating all diagnostic information."

The RSNA R&E Foundation is pleased
to have been an early catalyst of Dr.
Jarvik’s nearly two decades of research
aimed to improve patient care.